Provider Demographics
NPI:1669965570
Name:BECKTELL, LORELEI (OTD, MOT/R)
Entity type:Individual
Prefix:DR
First Name:LORELEI
Middle Name:
Last Name:BECKTELL
Suffix:
Gender:F
Credentials:OTD, MOT/R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27222 FULSHEAR BEND DR APT 2319
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1206
Mailing Address - Country:US
Mailing Address - Phone:281-221-9020
Mailing Address - Fax:
Practice Address - Street 1:2100 LOVERS LN
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64505-2246
Practice Address - Country:US
Practice Address - Phone:281-221-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0019X
MO2014024648225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation